Health Insurance Lifetime Maximum

The Health Insurance Lifetime Maximum of your plan is the total amount of money the insurance company will pay for the entire time you have coverage under that plan. Once you reach that amount, your plan will not pay for any more of your medical expenses.

What Are The Limits?

The maximum amount that the insurance company will pay varies from policy to policy, with the typical amount being between 1 million and 5 million dollars. There are some polices though, that only contribute a total of less than 1 million dollars over the lifetime of the policy.

On a brighter note, although not as common, there are policies that have an unlimited lifetime maximum.

Why Are There Limits?

Insurance companies set these limits to keep their total possible liability for a health insurance plan as low as possible.

Keeping these limits lower also keeps the premium rates lower. All of the guidelines of the plan, including the lifetime cap come into play when insurance companies set the cost of the insurance plan. A plan richer in benefits is going to cost more.

For instance, a health insurance plan with a high deductible and a low lifetime cap will cost less than a plan with a low deductible and unlimited lifetime benefits.

Similarly, when the annual deductibles of two plans are the same, the plan with a higher lifetime maximum will cost you more.

Should You Be Concerned?

You and your family members may be in perfect health and can never foresee that any one of you could possibly incur medical bills as high as one to five million dollars. And quite frankly, I hope you never do!

But, with the rising costs of medical treatment for conditions such as open heart surgery, cancer, organ transplants and chronic illnesses, it isn't that difficult to reach those amounts in a short amount of time.

If you want to be sure to be covered for all medical expenses for the duration of your coverage under that policy, look for one with a higher lifetime limit or one with no limit. To lessen the cost of these plans, consider accepting a higher annual deductible.

P.S. Consider this ~ A coverage cap of $1 million in the 1970s would have had to grow to more than $10 million today to keep pace with inflations and costs.